CQC report explained · a residential care home
What the CQC found at Weir End House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found that safeguarding incidents and unexplained injuries were not always properly reviewed or investigated. Risk assessments and care plans did not always explain known risks or how staff should respond.
- Effective?
- Good
- This question was not inspected during this focused inspection. The report says the previous rating was used when calculating the overall rating.
- Caring?
- Good
- This question was not inspected during this focused inspection. The report says the previous rating was used when calculating the overall rating.
- Responsive?
- Requires improvement
- Care plans were individualised and people had activities and support to use their local community. However, care plans were not always updated to reflect incidents and behaviours.
- Well-led?
- Requires improvement
- The provider had not reported three safeguarding incidents and its quality assurance systems had not found or fixed important shortfalls. Staff meetings, supervision and meetings for people using the service were not held regularly.
What inspectors found, December 2019
Weir End House rated Requires Improvement; inspectors found people were cared for kindly but safeguarding, care records and management checks were not reliable enough.
Inspectors visited on 15 and 19 November 2019. They spoke with people living at the home, relatives, staff and health and social care professionals. They reviewed care records, medicines records, complaints, staff recruitment files, incident records and safety checks.
The home was not always safe. Incidents, unexplained injuries and episodes of challenging behaviour were not always properly investigated or reflected in updated risk assessments and care plans. Three possible safeguarding incidents had not been reported to the CQC or the local authority until after the inspection.
There were also good points. People said they felt safe, had enough staff support and received their medicines safely. Care plans were personalised, people had activities and community links, and relatives found staff and management approachable. However, quality checks, meetings and staff supervision were not consistent enough to identify and fix problems.
The overall rating fell from Good at the previous inspection to Requires Improvement. This inspection only assessed Safe, Responsive and Well-led. Effective and Caring were not inspected, so their previous ratings were used in the overall rating.
Personalised care
Care plans were individual to each person and people were involved in developing them. Staff said the plans were easy to follow.
“People's care plans were individual to them and included information about what was important them to promote a person-centred approach.” from the report
Activities and community life
People were supported to take part in activities at the home, in the local community and at a day centre. Inspectors heard that people enjoyed these opportunities.
“They [staff and management] provide a good range of activities. I feel [person] has a rich life there [at the home].” from the report
Medicines
Inspectors found medicines records were accurate and current. Staff had training and regular checks of their medicines practice.
“Staff maintained accurate and up-to-date medicines records and completed daily medicine stock checks to confirm people had received their medicines as prescribed.” from the report
Clean and hygienic home
The home was clean and fresh-smelling. Staff had infection control training and access to protective equipment.
“Staff maintained appropriate standards of hygiene and cleanliness throughout the home, which was clean and fresh-smelling.” from the report
Safeguarding investigations
seriousIncidents involving people and unexplained injuries were not consistently reviewed or investigated. Three potential safeguarding incidents were not reported until after the inspection.
“The provider had not implemented robust procedures and processes to protect people from abuse and improper treatment.” from the report
Risk plans were not up to date
seriousRisk assessments and care plans did not always reflect incidents or challenging behaviour. Some records were unclear, incomplete or contradictory.
“People's risk assessment and care plans were not always reviewed and updated in light of incidents and episodes of challenging behaviour.” from the report
Weak quality checks
seriousThe provider's audits and checks had not identified or corrected the problems found by inspectors. The report also says meetings for people and staff, and staff supervision, were not regular.
“The provider's quality assurance systems and processes were not as effective as they needed to be.” from the report
Staff confidence
needs fixingSome staff lacked confidence about raising concerns, including possible safeguarding issues, with the registered manager. Staff also gave mixed views about how supported and valued they felt.
“Four members of staff expressed a lack of confidence about bringing concerns, including potential safeguarding issues, to the attention of the registered manager.” from the report
- 01How are safeguarding incidents and unexplained injuries now recorded, investigated and reported to the CQC and local authority?
- 02How do you make sure risk assessments and care plans are updated after incidents or episodes of challenging behaviour?
- 03What has changed in the quality assurance system since this inspection, and how do you check that it is working?
- 04How often are staff meetings and formal supervision now held, and how can staff raise concerns safely?
- 05How often are meetings held so people living at the home can give their views about their care and improvements?
This was a focused inspection of Safe, Responsive and Well-led only; Effective and Caring were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 28 December 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, February 2019
Rated Good; inspectors found kind, person-centred care and safe support, with some notification systems needing further development.
This was an unannounced, planned inspection on 15 January 2019. One inspector and an inspection manager observed care, spoke with five people, the registered manager and six care staff, and reviewed care, medicine, health and management records.
The home supported younger adults with learning disabilities and/or autism. Inspectors found people were safe, treated with dignity, involved in decisions and supported to enjoy activities, friendships, healthcare and time in the community.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. The home was already rated Good at the previous inspection in August 2016, and remained Good overall.
Inspectors noted that the home was larger than current best practice guidance for this type of service. They also found that systems for notifying CQC about some important events needed further development.
Respect and independence
People were supported to make everyday choices and to keep or develop their independence, including with personal care, laundry and their rooms.
“People's rights to dignity and independence was promoted by staff.” from the report
Kind relationships
Inspectors saw trusting relationships between people and staff. People enjoyed time with staff and friendships with others living at the home.
“People had built trusting bonds with the staff who cared for them.” from the report
Safe staffing and medicines
There were enough staff for people's care and activities. Staff were trained and checked as competent before giving medicines, which were regularly reviewed.
“There were sufficient staff to care for people and to do things they enjoyed doing.” from the report
Personalised activities
Activities reflected people's interests and included community trips, holidays, crafts and individual outings. Staff also supported people to stay connected with family and friends.
“The activities are very much about them as individuals.” from the report
Health support
Staff supported people to attend health appointments and followed advice from health professionals. Health action plans and hospital passports were in place.
“People told us staff promptly helped them to see their GPs if they were unwell.” from the report
Reporting important events
needs fixingThe registered manager had reported some significant events, but the systems for reporting other events to CQC needed more development. The manager said these systems would be reviewed.
“The systems in place to notify CQC of other events required further development.” from the report
Size of the home
minorThe home was larger than current best practice guidance for this type of service. Inspectors said the building helped reduce any negative impact, but families should ask how this works for their relative.
“This is larger than current best practice guidance.” from the report
- 01How have you improved the systems for notifying CQC about important events since this inspection?
- 02How does the size of the home affect daily life, privacy, noise and individual support?
- 03How will you provide information in accessible formats so my relative can make informed choices?
- 04How are activities planned around each person's interests, and how often can people go out individually?
- 05How will you involve my relative in planning future end of life care?
This was an unannounced planned inspection of the whole care home and all five CQC areas; the home was rated Good in every area. This explanation was written from the published report of 14 February 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Weir End House
3 rated inspections over 3 years: the service has slipped, from Good to Requires improvement.
- December 2019Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2019Goodstayed GoodSafe: GoodResponsive: GoodWell-led: Good
- August 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2014
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- February 2012
Registered with the Care Quality Commission on 5 February 2012.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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11 live-in carers within about an hour of Herefordshire, County of
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £960 to £1,410 a week. 10 can care for a couple. 8 years' experience on average.
“She was very caring, kind and patient to all his needs, she built up a wondetful rapport with him, she was dedicated and was there for him through good times as well as through the tough times”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.